What Is Intestinal Metaplasia?

Maggie J. Hall

Intestinal metaplasia generally involves the development of intestine like cells in locations where this type of cell is not normally found. The condition is usually attributed to chronic inflammation caused by bacteria, the person, or environmental factors. The differentiated cell type frequently develops in the stomach and esophageal regions but may occur anywhere in the body. Treatment may involve eliminating causative factors.

Doctors may diagnose intestinal metaplasia during an endoscopy.
Doctors may diagnose intestinal metaplasia during an endoscopy.

The condition generally occurs when a constant regenerative process turns normal squamous cells into columnar mucosa cells. The cell membranes and nuclei are usually distorted and have vacuoles that contain acidic mucin. As the name implies, the transformed cells resemble those found in the intestines. These abnormal cells fuse and may spread throughout the affected area. Though generally considered a benign change, the condition is often equated with pre-malignancy.

Gastric irritation may lead to the development of intestinal metaplasia.
Gastric irritation may lead to the development of intestinal metaplasia.

Focal intestinal metaplasia is one of two classifications of the condition and has two variations. This focal form usually occurs in response to chronic mucosal injury or irritation and is further classified as being complete or incomplete. Complete focal forms of the condition generally produce cells that resemble those commonly found in the small bowel. The cells undergo a maturation process that enables them to appear and function as bowel cells. They may secrete peptides and absorb nutrients.

Pathological stress caused by certain bacteria may lead to intestinal metaplasia.
Pathological stress caused by certain bacteria may lead to intestinal metaplasia.

The other variation of focal metaplasia is commonly referred to as incomplete intestinal metaplasia. In this form, the transformed cells are similar to the microscopic structures found in the large intestine. The affected organ generally contains goblet cells and rudimentary villi, often associated with the colon.

Diagnosis of intestinal metaplasia usually involves microscopic examination.
Diagnosis of intestinal metaplasia usually involves microscopic examination.

Mucus gland intestinal metaplasia usually develops secondary to ulcerative conditions. It is the second major classification of this condition. Erosion of gastric glands may eventually give way to the development of mucous glands.

Alcohol consumption may contribute to gastric irritation.
Alcohol consumption may contribute to gastric irritation.

Physicians may discover intestinal metaplasia during an endoscopic evaluation. Early stages of the condition often appear as white plaques or patches. The abnormal cells might also appear as discolored regions. Definitive diagnosis usually involves biopsy and microscopic examination. Under certain circumstances the condition may be reversible.

Pathological stress caused by Helicobacter pylori frequently induces inflammation and tissue ulceration, which may lead to intestinal metaplasia. Antibiotic treatment regimens can usually eliminate the bacteria and subsequent irritation. Physiological stress factors that contribute to gastric irritation include diets deficient in vitamin C, alcohol consumption, and smoking. Chronic use of non-steroidal anti-inflammatory medications may also create the condition.

Certain autoimmune diseases attack the parietal and chief cells of the stomach, creating chronic inflammation and injury. In many instances, reversing controllable factors allows tissues the opportunity to heal normally. Individuals having extensive or severe cases may undergo ablation or surgical removal of damaged tissue.

Chronic gastric inflammation can be sign of Intestinal metaplasia.
Chronic gastric inflammation can be sign of Intestinal metaplasia.

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Discussion Comments

Handycell

My doctor wants to do an endoscopy to rule out intestinal metaplasia, and the whole procedure has me a little on edge. I was wondering if there are other options for diagnosis? I keep hearing about capsule endoscopies, where you can swallow a capsule that has a camera inside. I’m wondering if that could be a good option for me. Just the idea of having an endoscopy is making me too nervous that I’m almost about to cancel my appointment. If capsule endoscopies are not an option, are there any alternatives?

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